Integrated health care for diabetics: a holistic approach

The current integrative review was conducted to seek evidence on integrated health care. The goal of this integrative literature review is to increase awareness of holistic approach in in-integrated health care for adult diabetic patients. The aim is to introduce healthcare services of diabetic patients successfully integrating mental and physical care to improve the medication adherence. The research questions of this study were: How can mental support be incorporated in the physical care of diabetic adult patients? How does integrated care assist diabetic adult patients in medication adherence? Integrative literature review was used as the method of this study. Data search was performed in September 2018 using 5 databases. After the evaluation process, 10 articles with varying designs were included. Critical Appraisal Skills program for cohort and qualitative studies and STROBE tools were used to evaluate the quality of the chosen articles for the integrative review. Evidence from the primary studies were extracted, analyzed and synthesized by themes. Four of the six elements of chronic care model- patient self-management support to assist patients to take active role in their care, clinical information systems, e.g. for providing feedback, and electronic registries and delivery system design to support prevention oriented clinical care and provide decision support, such as use of treatment guidelines or consulting with the expert were found to be the ways in which mental support was incorporated in the physical care of diabetic adult patients. Incorporation of financial, social, and emotional needs as part of primary care was also effective. The two elements; (Linkages to community resources and health care organization support) were not common. Evidence suggested that when mental health is detected and treated, symptoms subside, cognitive and behavioral functioning and overall quality of life improves. With the assistance of integrated care in medication adherence evidence shows that simple yet effective programs can help in improving adherence. Conducting integrated care intervention based on integrated care framework helps participants recognize depression in the context of Type 2 Diabetes. The outcomes are assessed using standard laboratory tests to measure glycemic control and the Center Epidemiologic Studies Depression Scale (CES-D) to assess depression. The creation and dissemination of frameworks that incorporate financial, social and emotional needs into care for Type 2 Diabetes and depression care will also enhance medical adherence. Interactive, monitoring and good follow up with patients can help in the adherence of medications for diabetic patients